Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

Progestin suppression for endometriosis before IVF

“Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients”, according to the Khalifa et al., from Egypt. Endometriosis is one of the leading reasons for infertility due to decreased oocyte/embryo quality, fertilizability, tubal function, and aberrant endometrial receptivity. In vitro fertilization (IVF) overcomes some mechanisms that lead to infertility in endometriosis patients including removal of oocytes from the toxic peritoneal environment, bypassing tubal factor, and improvement of endometrial receptivity. There are several IVF protocols that are preferred…

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Optimal management of infertility in endometriosis patients

Pelvic pain and infertility are the main symptoms of endometriosis patients. Although the pathophysiological mechanism for infertility is not clearly understood, there are several theories explaining decreased fertility potential in women with endometriosis. Ata and Telek, from Koc and Istanbul Universities of Istanbul, Turkey, recently published an opinion article entitled “Assisted reproductive technology for women with endometriosis, a clinically oriented review” in the journal named "Current Opinion in Obstetrics and Gynecology". The authors aimed to investigate the effect of endometriosis on assisted…

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Immune-mediated conditions and endometriosis in adolescents and adults

The most common presenting complaints of endometriosis are mainly pelvic pain and infertility, commonly in relation to the menstrual period. Affected women demand therapy for these symptoms. Immunologic diseases such as autoimmune and/or inflammatory diseases, allergies, asthma, previous mononucleosis infection, and chronic fatigue and/or fibromyalgia could be encountered in endometriosis patients due to underlying common etiopathogenetic mechanisms.  Shafrir et al, from the Brigham and Women’s Hospital and Boston Children’s Hospital, USA, published a prospective study titled “Co-occurrence of immune-mediated conditions…

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Postoperative treatment and pregnancy points to decreased recurrence risk for ovarian endometriosis

Endometriosis is a disease most frequently diagnosed in women of reproductive age and negatively affects the quality of life. The most common localization for endometriosis is ovaries with a prevalence of 17-44%. Laparoscopic ovarian cystectomy performed as excision or ablation has been accepted as the gold standard approach in these patients. Excision of all visible endometriotic lesions, and adhesiolysis are recommended to restore ovarian anatomy. However, postoperative recurrence can be encountered in women who underwent laparoscopic ovarian cystectomy despite excision of…

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Controlled use of bipolar cauterization as an alternative to endometrioma cystectomy

The main symptoms of endometriosis are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Ablation or coagulation of the cyst wall following laparoscopic drainage of endometrioma may be an alternative treatment for patients with pregnancy intention. Carbon dioxide, laser, and plasma energy and bipolar instruments could be used to achieve ablation. Endometrioma cystectomy may have a negative effect on ovarian function and may reduce the in vitro fertilization success. Chen et al., from the Assisted Reproduction Unitof Sir Run Run Shaw Hospital, School…

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“Advanced gynecological ultrasound” for women with suspected endometriosis

Different clinical forms of endometriosis such as superficial endometriosis, endometrioma, and deep infiltrating endometriosis are present. Although no specific diagnostic tool is available for endometriosis, clinical findings, physical examination and imaging including transvaginal ultrasound and MRI are helpful to determine the treatment and to counsel these patients. Menakaya et al., from Australia and New Zealand, published a study entitled “Awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women planning surgery for endometriosis: A survey of RANZCOG…

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Managing the physical and emotional effects of endometriosis

Endometriosis is known to affect 5-10% of the general population, but some women are underdiagnosed due to physical and psychological disability. Due to the symptoms including dysmenorrhea, dyspareunia, chronic pelvic pain and infertility, endometriosis has a negative effect on the quality of life. The social life of women with endometriosis is disrupted during their menstrual periods. As a result, the patients with endometriosis may also be stigmatized by their partners due to the experiences about the disease. The supportive approach of…

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Impaired fertility potential in endometriosis patients

Infertility is frequently encountered in endometriosis patients because of anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis and sperm movements. Garcia-Fernandez and García-Velasco, from Edinburgh, UK and Madrid, Spain, published a mini-review titled “Endometriosis and Reproduction: What We Have Learned” in the "Yale Journal of Biology and Medicine". The authors aimed to evaluate all aspects of the relationship between endometriosis and infertility, and suggest preventive measures.  Even though disease stage and presence of endometrioma are negatively correlated with fertility,…

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Vitamin D supplementation, endometriosis symptoms and metabolic profiles

Patients with endometriosis suffer from dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. These women are also at higher risk for ovarian and breast cancer, cardiovascular events, and metabolic abnormalities. Several medical and surgical alternatives have been recommended to these patients to increase their quality of life and prevent associated morbidities. Vitamin D has been suggested for its ability to improve endometriosis-related immunological functions as it plays an important role in the regulation of immunologic mechanisms. To investigate the effect of…

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Self-management and the quality of life in women with endometriosis

Endometriosis symptoms can range from mild to severe. The most common presenting complaints are mainly pelvic pain and infertility. There is no doubt that the physical and mental quality of life of these women is adversely affected. There are several studies evaluating the quality of life in endometriosis patients in a hospital or clinic setting. However, the effect of self-management factors on physical and mental quality of life in a community setting has not been investigated. O’Hara et al,  from Australia,…

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Live Birth Rate in Women Who Underwent Fresh Embryo Transfer Using Freshly Retrieved Donor Oocytes

One of the important clinical findings in women with endometriosis is reproductive problems. Infertility can be encountered in up to 50% of women with endometriosis and up to 50% of women with infertility can be diagnosed with endometriosis. Several pathophysiologic mechanisms have been proposed for the development of infertility in endometriosis patients, such as anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis, and sperm movements. Assisted reproduction technology is the most frequently preferred treatment approach in women having endometriosis.…

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Postoperative pregnancy rate in infertile women with deep infiltrating endometriosis

Deep infiltrating endometriosis (DIE) is fibrous/muscular infiltration of organs and anatomical structures containing endometrial tissue below the peritoneum regardless of the depth of infiltration. Another definition describes DIE as infiltration of the peritoneum by endometriotic lesions deeper than 5 mm. Pain, subfertility/infertility are the main clinical symptoms of these patients in whom surgical removal of all endometriotic lesions is required due to better outcomes in pain and fertility relief. To investigate the impact of surgeon’s experience on postoperative spontaneous pregnancy rate,…

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Implantation failure in endometriosis patients - Jovana Lekovich, MD., PhD.

Endometriosis is one of the leading reasons for infertility due to decreased oocyte/embryo quality, fertilization ability, tubal function, and aberrant endometrial receptivity. Whether this failure is caused by oocyte/embryo or eutopic endometrium is one of the investigated topics in endometriosis research. Although previous studies claimed that abnormal oocyte/embryo development results in infertility in endometriosis patients, it is known that the endometrium has an important role in the clinical pregnancy rate and live birth rate based on recent publications. When eutopic…

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In vitro fertilization protocols in endometriosis patients - Pinar Kodaman, MD., PhD.

Infertility is frequently encountered in endometriosis patients because of anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis, and sperm movements. Even though the disease stage and presence of endometrioma is negatively correlated with infertility, it is unpredictable which women are at higher risk for this problem. Endometriosis fertility index (EFI) considering female age, years of infertility, prior pregnancy status, least function score, and American Fertility Society score can be used for this aim, and higher EFI score is associated…

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Endometrioma size and anti-Müllerian hormone levels

Endometriotic lesions are encountered in different locations in the pelvic cavity, including but not limited to the ovaries, the pouch of Douglas, the ureters, the bladder, and the bowel. Cystic endometriosis lesions located in the ovary are called "endometrioma". Endometriomas have the risk of impairing ovarian reserve, which defines the capacity of the ovaries. One of the reliable independent markers of ovarian reserve is the anti-Müllerian hormone that is produced by preantral and small antral follicles. Knowing the level of preoperative…

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Reduced risk of "small for gestational age baby" following frozen embryo transfer in endometriosis patients

Infertility is encountered frequently in patients with endometriosis. These women could be managed using assisted reproductive technology (ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to achieve pregnancy. However, some adverse obstetric and perinatal outcomes are experienced more commonly in these pregnancies due to the intrinsic and/or extrinsic characteristics of the patients. Ovarian stimulation protocols, laboratory techniques, type of embryo transfer, altered implantation and subsequent placental function, local disturbances during the embryo transfer, hormonal stimulation on the endometrium,…

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Segmental bowel resection could be predicted using MRI in patients with rectal endometriosis

The rectum and recto-sigmoid junction are the preferential localisations of bowel endometriosis. The three main surgical approaches are shaving, disc excision, and segmental resection. It is very important to decide the most appropriate surgical method preoperatively and to plan accordingly.  Currently, there is no international consensus on the surgical approach for lesions involving the rectum and recto-sigmoid junction, however, a superficial infiltration is generally managed by rectal shaving but, for deeper or larger infiltrations, the radical segmental resection approach with…

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Psychometric properties of Endometriosis Health survey-Swedish version

Endometriosis is a chronic estrogen-dependent disease resulting in a broad spectrum of symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Additionally, gastrointestinal and urinary systems may be affected by this disease. All of these clinical findings impair health-related quality of life which is difficult to define. Several generic surveys have been used to understand the physical, mental, social, and psychosexual well-being of these patients. However, none could measure the degree of the quality of life accurately due…

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Depression and anxiety levels in "in vitro fertilization" patients with endometriosis

Endometriosis is a reproductive-aged and estrogen-dependent disease. The most common symptoms of this disease are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility affecting the quality of life in several aspects mainly the psychological domain. In the literature, there are many studies reporting higher levels of depression and anxiety in these women. Medications in the treatment of endometriosis, some familial risk factors, and the underlying mechanisms of endometriosis including neuroinflammation, autoimmunity dysregulation may contribute the mood changes in the patients with endometriosis. Ceran…

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Sleep Quality, Lifestyle Factors and Endometriosis

Endometriosis does not only affect the patients by dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. An important issue in these patients, like other chronic diseases, is sleep quality. Youseflu et al., from Iran, published a study entitled “Effects of endometriosis on sleep quality of women: does lifestyle factor make a difference?” in the journal "BMC Women’s Health". The authors aimed to assess the impact of lifestyle factors such as physical activity levels, diet, body mass index, cigarette smoking on the…

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